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By Samantha Thurlby-BrooksToday Amnesty International and One Billion Rising are campaigning together for women’s rights. They are encouraging everyone across the world to support the elimination of violence against women and girls. I think in the light of recent events, such as the horrific Delhi gang rape that happened in December 2012, this day is much needed.

We usually think of violence against a woman as being rape, beaten or emotionally abused, often by someone they are in a relationship with or someone else they know. Domestic violence is a serious issue and society is working together to find out what is going on behind closed doors and helping women in need. Sadly the prevalence of abuse specifically during pregnancy is rarely thought of yet 20% of pregnant women will suffer at the hands of their partner. This is unacceptable.

“It is estimated that one in five women will be abused during pregnancy. As homicide during pregnancy now surpasses the previous leading causes of death (automobile accidents and falls), it is more important than ever that we know the signs and properly screen women for domestic violence.” About.com

What I’d like to talk about here is the socially acceptable physical violence and emotional abuse pregnant and birthing women suffer. The abuse that leaves a woman feeling unworthy, incapable, doubting her abilities, fearful and physically and emotionally scarred. This is also the abuse that makes a woman feel like she deserved it, that there was something she did wrong to bring it on herself, that ‘it’s just what happens’ and brush it under the carpet to suffer in silence. It’s the socially acceptable abuse that leaves new mothers depressed and anxious or in a state of shock and numbness. Sometimes (and probably more frequently than is recorded) these women suffer post-traumatic stress disorder.

This violence I’m talking about is the way pregnant women are treated by the health profession in general and some health professionals (obstetricians and midwives). The problem is widespread because no one talks about it as being abuse and so many of the health professionals don’t even realise they are being abusive and how their words and actions affect a person. The Nocebo Effect is a term that is used when someone says something negative to a person and the person responds negatively. For instance, “your baby is measuring big” at 20 something weeks gestation sets a woman up to believe that her baby may be too big to be born vaginally. She wonders over the next few months how she would ever get a large baby out without tearing her perineum. When her healthcare provider then offers her the opportunity of an early induction or caesarean she is likely to accept.

Instead, it would be great if the healthcare provider didn’t comment on baby’s size or alternatively could say “Wonderful, your baby’s growing healthy and big. Just what we want. So long as you’re eating healthy foods this is great.” I had a client a couple of years ago who birthed an 11lb baby. She didn’t realise she was in labour because she wasn’t in much pain but, on a routine visit to her midwife, her midwife got suspicious and asked to do a vaginal exam. It turned out she was fully dilated and her waters had broken! She walked down to the labour ward and six pushes later her baby was born… no stitches, no tearing. It’s not the size of the baby that causes problems, it’s whether mum and baby are able to get into good positions and move together.

A client came to me for a postnatal massage a few months ago. She was feeling quite traumatised by her birth and the way she was treated. She had assumed that having a female private obstetrician would give her the best care available. Among some of the things that happened during her birth, the obstetrician, whilst stitching up her torn perineum, said she wasn’t surprised it happened as she [the mother] was overweight and probably sat around in cafes drinking coffee and eating cake. Besides the woman not being overweight at all this was horrendously inappropriate!

Pregnancy, birth and new motherhood is a time when a woman is at her most vulnerable. Her hormones for love and calm have increased since conception and during labour these hormones are peaking higher than any other situation can create. This love hormone, Oxytocin, is the creator of labour contractions. To feel the love and calmness of the hormone Oxytocin there needs to be an absence of the stress hormone Adrenaline. Adrenaline blocks Oxytocin. In otherwords, a woman must feel safe, confident and protected for Oxytocin to peek, giving her and her baby the safest and most empowering experience of birth.

Here are just a few facts about birth that are widely known;

A labouring woman must feel safe and relaxed

The safety of birth increases when a woman is continuously supported

A woman will birth her best where she feels safest; this can be a hospital, home or birth centre

Movement during labour reduces the experience of pain

Movement during labour helps baby position correctly for a safe, un-assisted vaginal birth

Lying on your back or semi-reclining during labour and birth is more painful, uses up more energy and is less effective than forward leaning, upright positions.

Forceful pushing can damage blood vessels in the mother’s eyes, create back pain and headaches

Forceful pushing won’t get a baby out if the baby’s shoulders are not in the pelvic brim… but moving around will

Foetal distress is frequently relieved if the labouring woman changes position (normally if she gets off her back)

IV fluid, necessary for epidurals, creates a bloated mother and baby and difficulty with feeding from bloated breasts, as well as diluting the mother’s blood which increases the chance of haemorrage

Hospital policies are largely there to protect the hospital against law suits

Even though we know all of these to be true, many health professionals still offer inductions without medical cause, offer epidurals as routine, require a woman birth on her back/semi-reclining with her feet in stirrups or more fashionably now with her feet pressed on the hip of a person on either side. If we know these things to be harder for the woman, but easier for the health professional, how can this not be abuse? How can forcing a woman to lie on her back, despite her saying no, saying she wants to be upright, saying that it hurts more, not be abuse and violence? This is an abuse of power, knocking a woman’s confidence and intuition that she knows her own body. How can doing an episiotomy (surgically cutting the perineum) or the perineum tearing because of this unfavourable position not be an act of violence against women?

Women who have suffered rape, sexual assault and other types of abuse (including emotional abuse) will agree that this creates the same feeling of helplessness, shame and guilt.

During labour, telling a woman that if she doesn’t birth her baby within two hours they will do a ceasarean is like telling a man that he has to have an orgasm within the next three minutes or they will cut the end of his penis…. except what they are threatening the woman with is major surgery. A woman doesn’t need to know what might happen while she’s in labour as this will disrupt her feelings of safety and the release of hormones that will improve her chances of a safe and easy birth.

These labour hormones are the same as the sex hormones. Imagine how each person would feel if the other said, during sex, “You’re not doing it right”, “Your penis isn’t big enough”, “Stay still”, “This isn’t about your pleasure”, “You’re no good at this because you’re too fat, too old, too sick, too tired”.

The health profession know this about birth. Doctors and midwives know that a woman must feel safe and confident and keep moving to have a good birth. However, when they don’t act for the whole good of the mother and baby, I believe they are putting themselves in the position of abuser. Hospital policies are not law yet they are pushed onto a healthy labouring woman as though they are.

Now, I’m not saying all obstetricians and midwives are abusers. I know many wonderful health professionals who do a truely amazing job at supporting women. But, having massaged over 2000 pregnant women and new mothers over the last seven years I have heard many, many wonderful and awful stories. A student of mine called me up recently feeling very upset about the way her midwife treated her during her birth. Upon arrival her midwife said she’d have to cancel her beauty appointment to be here, giving the labouring woman the strong feeling that her being in labour was such an incovenience. She was then set up for feeling guilty and also untrusting of her midwife and all that happened thereafter.

I’ve had many clients complain of painful vaginal exams during labour. Despite protests these women are often ignored, told to suck it up or reassured that it needs to be done and it’ll be over soon. How familiar this is to a child suffering sexual abuse from a person they know?Vaginal exams give very little useful information when done routinely. A cervix can dilate and contract very quickly or very slowly and still be part of a safe birth. The dilation of the cervix doesn’t tell us how soon a baby will be born… there are many other factors that affect this.

One midwife, during a birth I attended, carried out a vaginal exam during a contraction, despite it being more painful, and causing the woman’s waters to break (technically a surgical procedure). The midwife turned around and said that is was common for that to happen when doing a vaginal exam through a contraction. It is common for medical professionals to do these types of procedures ‘accidentally’ without the person’s consent, increasing the risks of birth and violating the person’s human rights of choice.

I have frequently heard of women being given Pethidene, an opiate based drug that strongly affects the mother and baby, without their permission. They weren’t told what it was or what the risks of it were before it being administered, with at least one woman being left on her own for the experience. The biggest fears humans have is to be abandoned in our time of need and to be held against our will. Labouring women are often subjected to both.

I could write a whole book about the stories I’ve heard, first hand, from women about their treatment through pregnancies and birth. About caesareans that weren’t necessary, about the terminology used by the medical profession (failure to progress is actually a successful protection of the baby, something I call the Lion Effect), the lack of scientific evidence for many diagnosed cases of cephalopelvic disproportion (baby too big for the pelvis), of women not being believed when they say how labour feels, that baby’s coming soon or that they are in labour at all. Of women, successful, well educated women, being called a ‘good girl’, of being ridiculed when she says she wants a natural, unmedicated birth, of being pressured into consenting to a procedure (often with the ‘your baby might die if we don’t do this’ threat for something that carries a very small risk).

So, yes, many midwives and obstetrician’s are wonderfully caring and supportive. But, there are equally as many who subject women to this socially approved low and high level abuse creating mothers who doubt themselves, go away feeling that birth was a trauma best forgotten, that they were ‘saved’ by a terrible experience, that their body’s don’t work and that other people know what’s best for them and their baby.

When we change the way pregnant women are treated, how society prepares women for birth and nurtures new mothers, when we train healthcare professionals and update hospital policies with the latest sound research… then we will be on our way to creating a society without violence.

Bethany, I’m so sorry to hear that happened to you. I don’t know any medical reason to tie tubes, and that certainly isn’t informed consent. It may be possible to reverse the procedure? Do you think you will report him/her for this? I need to post an article about VBAC (vaginal birth after caesarean) as it is, in most cases, a safe option… so I do hope you will one day have more children.

Yeahy! Well done you! So many doctors tell people they can’t have a vaginal birth after two caesareans. It’s just not true! Scar tissue is strong! When women start taking back their power, telling the system how they have been affected then we might get somewhere. Most doctors and midwives don’t see a woman past 6 weeks after birth so they don’t see the impact they are having on women’s lives

That is terrible! I had a vaginal birth after 2 csections. My Dr. refused to do it until I slammed her with facts and articles showing it is possible. I would report him or her in a heart beat. That is unacceptable!

I cant agree more with this, I am a young mum with two girls, and both times I have had horrific labours with both of them… I am now too scared to have another child and too scared to get a paps smear test after a midwife forgot to shut the tongs while she was checking if my waters broke and then my second childs labor was just the icing to the cake, epidural fell out, was yelled at because I was in pain and they didn’t believe me the list goes on… safe to say My partner better bloody spoil me pretty bloody good if I ever decide to have another baby.

Hi Monica, I’m so, so sorry to hear this. Sadly the medical profession only see women after a few weeks of birth, not when the bombshell really hits. I’m not sure where you live but there’s a fantastic childbirth education organisation http://www.birthworks.org who I’m sure would be fantastic for your recovery and in helping you prepare and find the right birth team for you.

I appreciate that giving birth in the 21st century can be a lottery with the care that you receive and have heard and seen many cases where I would be in court if it happened to me — and to my shame when inexperienced and overworked my own care may well be considered by myself and others less than optimal — but in general I don’t think people go into the profession to be cruel. Insensitivity and lack of time is not unique to our profession. I apologise to women all over the world if we have not been “with woman” as much as we should have been — but please remember that many of us strive to provide good care, which may at times include hard to hear facts from well researched evidence about the potential risks involved in childbirth — hopefully we provide it in a neutral and unbiased way and will then support women in the choices they then make for their own bodies and babies — but many women are also somewhat naive and uninformed and live in a blissful bubble of hope and would give us a lot of grief if an unexpected complication occurred that nobody had ever told them about.

Hi Suki, thanks for your comments and I see where you’re coming from. Unfortunately the sorts of things I’m describing above are happening with very experienced medical professionals as a standard way that they support women. I agree they aren’t trying to be cruel, they don’t even understand that they are. This is why the title of my article is the ‘socially accepted violence against pregnant and laouring women’… it’s so socially accepted we don’t see it for what it is. I’ve just started reading Henci Goer’s new book ‘Optimal Care in Childbirth’ (very, very good read) and the quote that springs to mind reading your comment is “… because in the end it does not matter what is in the care provider’s heart; the harm done to mothers and babies is the same” (p.2). Sadly insensitivity isn’t unique to the maternity system but it’s one of the areas where it is essential. Supporting oxytocin should be the maternity system’s number one priority. Also, you’re right… women need better education. You can’t educate a woman in labour, that’s meant to happen long before birth so she can make the right choices for her. That’s why I love the http://www.birthworks.org courses as they are the only ones I’ve found that offer a truely wholistic approach.

Thank you for the personal reply — I did enjoy your article and felt it was well balanced — just such a shame to see the reposts describing how many women out there are so unhappy with what should be as enpowering an experience as possible.

Wow, your reply was very condescending. A blissful bubble? How insulting! I work with many birth professionals and I can tell you several things here. #1 Doctors (and midwives too) very much work from fear and not by what the Academy of Obstetricians recommends. They work from fear of being sued and fear of their malpractice companies. #2. Birth is not a medical procedure, it is a biological function that gets turned into a medical procedure and emergency C Section by placing instruments into women’s wombs and medications into their veins and spines. #3 Doctors do not trust a woman’s body to birth her child without intervention and are not respectful of the birth experience. If I had the opportunity to vote, all OBs and CNMs would be required to follow around a CPM for a year and get signed off on procedures (including hands off practices) before being allowed to ever practice obstetrics.

Gaela, you spoke my heart. Even very well meaning doctors are victims of the lawsuit/malpractice monsters. It would take the lot of them to decide that ‘First Do No Harm’ wasn’t just something that looked good on a key chain to affect some real change in the system.

Great article! Thanks….As I doula I have to process my second hand trauma a lot around this issue. I do my best to advocate, info and empower but time and time again I still see the painful vaginal exams, extreme perineal massage, and the excessive pulling of the cord and placenta. It nuts and horrific to watch when you know there are more gentle and loving ways! Afterward I don’t always know how to talk about what I’ve seen and sometimes I ask myself “Is it my responsibility to point out what I considered abusive , even if my client isn’t talking about it?”
Thanks again for writing about this!

Hi Racquel, thanks for commenting! Wouldn’t it be great if doulas had a peer group they could talk all this stuff through with. I often feel we’re left on our own to see/experience some really stressful things. I cried for two days after attending my first birth. It would be phenomenal if doulas and the medical professionals could get together and really listen to each other. I’m doing a two hour talk next month at Auckland City Hospital to the midwives and obstetricians here in New Zealand about this very article. I’m not sure if as a doula we should tell a woman she was abused but maybe ask her how she felt about the care she was given. Some people may feel something was wrong but not understand what. Others may not be bothered by the way they were treated. Putting ideas into their heads may change their whole experience.

From personal experience I can agree to what is said- however- I support of a woman’s right to be educated about the size of her expected baby. There are hundreds of women in our support group with children injured after shoulder dystocia birth. These babies suffer life long paralysis of upper extremity which includes many complications and in worse cases brain damage. Many of these mothers have permanent damage and have pain when walking, sitting, exercising and during pregnancy years after a shoulder dystocia birth. Most often women are not educated about their risk of shoulder dystocia. I think ideally a doctor would help parents prepare for birthing a large baby and teach/refresh the hospital staff with the correct maneuvers to save a baby’s life when trapped and free the baby without life long injury. If mothers went into the delivery room prepared for this complication they might have more say in what they would like to do about it when it occurs. This week is Erb’s Palsy Awareness Week and in honor of that we are promoting women’s & infant health through prenatal education.

Hi BPI Mommy, thanks for your comments. Have you heard of the Gaskin Manouvre? Many shoulder dystocia’s happen when a woman is on her back… being on all fours helps the baby rotate and get their shoulders into the pelvis correctly. Small babies can get stuck too… it’s mostly about movement and allowing baby the time and space to turn without speeding things along artificially so when the head comes out the shoulders are either already in the pelvis or are free to move swiftly. A caesarean for a large baby certainly isn’t the only answer as I’ve known so many women have wonderful births with much larger babies. I think childbirth educators need to be educating better as not all doctors have the right philosophy or time to read all the research.

The ubpn website (www.ubpn.org) has great prevention information. Unfortunately in most cases the hospital staff did not perform the correct maneuvers. The midwife has to apply at least 60lbs of pressure pulling on the baby’s neck to cause the damage that all these children have- it’s heartbreaking. In many cases the babies required resuscitation and have permanent damage that causes a cascading affect on their health throughout their lives. Education about positioning and maneuvers should be included in prenatal care -every woman should have the right to be educated about birth injury prevention.

Many also happen when in all fours (I have personally witnessed 8 shoulder dystiocia’s and 6 of those women were on their knees). The Gaskin manoeuvre has a similar effect as McRoberts – its not actually being on all fours which prevents/relieves the shoulder dystocia its the movement of getting into position which helps the shoulder to slip under they symphisis.
I completely agree that small babies get themselves into awkward positions too (50% of shoulder dyctocia’s are of babies on the lower weight sizes) and that preforming a caesarean section for large babies is certainly not going to reduce the incidence of poor outcomes. HCPs need to all have correct and evidence based training to ensure that women and babies have the best outcomes possible.
(I refrain from using phrases like ‘get stuck’ – can make women feel they have an abnormal pelvis which doesn’t allow them to birth)

I had a midwife curse me, tell me I was effed in the head, left me alone overnight in the birthing bed only to have some wigged-out mom staying at the home, who had just lost her baby, crawl into the bed with me and begin petting me and freaking me out. Hell no, I didn’t feel safe. Was I abused by a cocaine-addict midwife? You bet. Did I have my child there? After a day and I half the midwife finally sent me to the ER. Pretty horrific and I’m sparing details.

HOWEVER, as much as I appreciate the point being stressed here, the equivalency you are attempting to create between the birthing process and all the adjunct idiocy and thoughtlessness simply does not exist.

You discredit your point in your attempt to elevate and dramatize it with a particularly volatile terminology. The very real and troubling trend of violence and rape against women and the attempts to highlight it are not served well by calling everything rape and violence. This is a common fallacy to which many women writers are susceptible. It’s fine language for a personal journal, but it doesn’t stand up in the broader scope of trying to focus purposeful energy on a problem. If everything is violence, it loses its meaning.

Hi Joan, thank you for commenting. It sounds like you had a horrific experience. One woman’s experience of birth should never discount another woman’s experience of birth. Trauma is trauma, violence is violence no matter what the degree or intentions of the assailant. It is never acceptable. The body parts for birth and sex are the same and some of the manipulative ways are the same, hence why many women who have had experience of sexual assault are triggered during traumatic births. My writing is not based on a whimsicle journal but on the 2000+ women’s accounts of pregnancy and birth that I’ve accumulated over the last 8 years through my clients, births and students as well as the many books I have read.

Your experience is yours. You discredit others’ experience and succumb to another common fallacy by accusing the author of dramatization. You do not appreciate the point, because you do not know.

I had a PPH after my c-section under general, and once they finally accepted my claim I was still bleeding (blood pressure drop finally convinced them), the practitioners first chose to try to stop the bleeding manually. I.e. several fingers repeatedly rammed up my vagina while pressing hard on my abdomen (reminder – this is post C-section and I was not at all dilated). When that didn’t work, one male doctor thought shoving some gauze on forceps up to my uterus might be more comfortable/successful than fingers. He seemed really surprised that this made me scream instead of being the great idea he imagined.

When they finally arranged for transfusions, they stuck a needle into my wrist three times but failed to find a vein. So they stuck it into my foot instead, which was far more painful than the three holes in my arm.

In my state of semi-consciousness, I literally thought I was going to die before I saw my first child while the doctors tried to figure out what to do to me next.

This violent treatment didn’t work. They ended up using the drugs they were trying to avoid.

Is it OK that they did this violence, because it was “for my own good”? Is it less worthy of society’s consideration? Did I suffer more or less than a date rape victim? Is it a coincidence that I couldn’t bear penetrative sex for more than a year afterward, still (after almost 9 years) overreact physically to surprise contact, and often have panic reactions when my chest or abdomen is compressed?

It is not all idiocy and thoughtlessness. Some of it is physical violence.

Jess, thank you so much for commenting and sharing such a difficult story. It’s for people like you I wrote this article for. To recognise that what you went through was violence and not ‘just medicine’. I did my talk at Auckland Hospital today and over the other study sessions I found out that in the third year at university medical students become so numb to the suffering of others compared to their first year. Imagine a doctor who’s been practicing for years… they are taught to separate themselves from the ‘patient’ so they can ‘do their job’. I get that PPH is very traumatic for medical professionals but they still need to treat women, the person in front of them, with respect and dignity. It would be great if they had heart felt, honest de-briefing sessions with women after birth and a few months after again to really listen and hear what it was like for them. This would go a long way to helping you heal I think.

This is to Mumanu – I did get a chance to meet with some of the medical staff involved afterward to debrief. It was not at all satisfying, as they were dismissive of my experience and defensive about what they did agree happened. If I described something that wasn’t written in the notes, I could see them dismiss it, yet “we can’t write everything down.” There were so many doctors involved, yet not all attended, and those who attended the session claimed their care had been suitable even if I wasn’t happy about other parts.

In any case, I really appreciate what you are discussing, and I feel a blog post coming on.

Hi Jess, that doesn’t surprise me at all. The medical profession will blame the woman/patient first before themselves. This is why I said an honest, heart felt discussion. I will keep pushing with this topic throughout the maternity community because it’s so important as you already know.

Unfortunately I agree with a lot of this as the birth of my son 2.5 years ago was horrendous and has left him with a bpi…me with major depression and a life which is way more difficult than need be. We knew nothing of shoulder dystocia before his birth and I am and probably will always be “pissed off” that it was all quite likely preventable.

Hi Cheryl, thank you for commenting. I’m so sad you went through this. We all do our best with the knowledge we have… I would love to see childbirth educators educating better and midwives and obstetricians supporting women better and then we wouldn’t have women carrying this life long burden

With my 1st child i was left to give birth alone in the hospital room after the nurse told me i was “nothing but a stupid child” with “no idea and had another 2 days before i would deliver” after I told them it was time to push!

You wonder why someone so rude and horrible would be able to get a job like this 🙁 And voila! What an amazing woman you are for getting on and doing what your body was made for. What did she say to you when she came back and found baby already born?

I can sense a real hatred for the obstetric and midwifery community within your article.Although some of your comments are accurate and I completely agree that SOME health care providers do abuse women, I truly believe they are the minority (Also agree that this ‘care’ which is being given by the minority needs to be stopped) but…

I am a student midwife and feel that your article (which im sure will/has been read by thousands of pregnant women) may be very misleading. For example in the part where you list ‘facts about birth’ –

‘IV fluid, necessary for epidurals, creates a bloated mother and baby and difficulty with feeding from bloated breasts, as well as diluting the mother’s blood which increases the chance of haemorrage’

This is completely non evidence based. There are several valid reasons that IV fluids may be recommended to a woman with an epidural for both maternal and fetal well being. If fluids were recommended a strict fluid balance chart should also be commenced – if the urine output was too little the fluids would immediately be stopped.to prevent any fluid overloading. (Often fluids wouldn’t be commenced – ketonuria/hypotension would be an indication to recommend this) (For the record I hate epidurals, and I completely understand and agree they are a massive intervention which is often given lightly, but if a mother is requesting I am not going to deny)

I just get a huge sense of mistrust from your article, and if I were a pregnant (non student midwife) woman reading this I would instantly fear having contact with any midwives or obstetricians. Like you state, women must feel safe and relaxed to labour and birth – Most women do seek care from HCP’s and I think this negativity could really hinder relationships which some mothers may not have even yet started. This is certainly not going to create a safe and calm atmosphere.

It’s hugely important that the subject of abuse in pregnancy and beyond does get heard and I commend you for getting the message out there but women also need to know not EVERY midwife and not EVERY obstetrician is going to abuse them. Women need to hear about the positive experiences of their fellow mothers to become empowered

Just wanted to add –
Women should 110% be informed on their baba’s size throughout pregnancy. Not by making comments like ‘oh your getting big’ but they defiantly need to know if there are any concerns, not discussing this with a mother is completely un-ethical!

It depends on whether you believe big babies can be born safely or not. Making a comment with a positive attitude and encouragement is good. There are obstetricians I know who will frequently tell women at 28 weeks their baby is measuring big and will need a caesarean. This is un-ethical

GreenTea Ganesha, I absolutely agree with you! I am a labor and delivery nurse and certainly try to honor my patient’s wishes even if I do not personally agree with them.

Mumanu, a baby being large for gestational age can mean many things. Sometimes it is indicative of a medical problem, such as uncontrolled gestational diabetes. Typical familial size differences do not show up until the later stages of the third trimester, not at 20 weeks. Yes, we need to respect women, but not at the risk of the mother and baby’s health.

You also refer to women laboring on their backs. Any obstetrical healthcare provider with basic knowledge knows a pregnant patient should never lay flat on her back. The weight of the uterus sits on the inferior vena cava and decreases perfusion to the baby. A good provider will encourage the patient to move. If she chooses and epidural, the nurses should be assisting the patient to change positions frequently. I have even had patients with epidurals up on all fours in the bed. The beds are also advanced enough to place a patient in the squatting position with the epidural. Women with epidurals are not inferior or making a bad decision. It is just different from what you would choose. Allow them the same courtesy you are requesting for yourself.

I feel this article portrays most healthcare professionals as an abusive enemy. You are furthering the gap between patients and practitioners. Why not write an article that emphasizes the need for communication between the patient and providers before care commences. Patients can interview obstetricians and midwives to make sure they have similar philosophies.

Hi Alex, thank you for your comments, all of which I am well read about. You are obviously a well researched nurse and look after women well. Sadly, there are many cases where women aren’t. Just read the stories here and have a look at the national statistics. I am not furthering the gap, I am pointing out a problem that gets swept under the carpet. A problem that is very real and why so many women don’t enjoy birth. I am in the process of writing another article on ‘consumer rights’ within the healthcare system.

Hi Green Tea, thank you for your comments. No, I don’t have a hatred of the medical profession. After interviewing 2000+ women I have heard far too many terrible stories. This idea that the profession is, for the most part, supportive and caring just isn’t playing out in reality. There are far too many unnecessary epidurals, episiotomies and caesareans. Far too many women feeling traumatised by birth. When you’ve heard as many stories as I have you start to see a clearer picture of the situation. The fear of litigation is clouding the decision making process. People study midwifery because they love babies and birth and want to make a difference. Somewhere along the way something is going wrong and many of these midwives and obstetricians are hardening up. Postnatal depression is on the rise, postpartum haemorraging is on the rise… all things that frequently happen when we don’t respect oxytocin. My reason for putting the information about IV’s is because offering an epidural as standard, which requires IV fluids, leads to higher risk. This article is about the socially accepted/unnoticed violence against pregnant and labouring women… not an article about lovely births. People can read those stories on my website http://www.joyfulchildbirth.co.nz This is a hugely important topic that shouldn’t be sugar coated and women need to understand their rights and be prepared to calmly and assertively state what they need… but most importantly choose their care provider with a more informed attitude.

GreenTea, I agree that not every OB or midwife is abusive. However, I am a woman that had great trust in my OB and expected that under her care I’d be respected and treated well. I was wrong, and my trust was completely betrayed. I ended up very damaged physically and emotionally, and it affected my family in very negative ways during what should have been a happy time. I think this happens ALL the time, and ALL women need to be aware of the possibility so they know what to do if they feel abused or neglected by their providers. It is to important and too serious to just say,
“that’s the exception, not the rule.” If it is the exception, and I’m not sure it is, then we need to be prepared for how to deal with it as women, moms and advocates.

Big babies are born every day and I am a firm believer that a woman’s body will not grow a baby it cannot birth – but if a woman is measuring off the scale it *could* have dire consequences which shouldn’t be brushed over, its her body she has the right to know. As for obstetricians lying about size that’s a whole other matter.
I do agree that the fear of litigation plays hugely in the care given but most guidelines (here in the UK) are based on sound up to date evidence. HCPs often forget that these are just guidelines though and women can deviate from them.
I defiantly didn’t start my midwifery journey for a love of babies, but I did and still do want to make a difference. Obstetricians are what I would call ‘harmed individuals’ they are the ones who have seen poor outcome after poor outcome as they do constantly deal with the ‘high risk’ women. This must make them hardened to some extend – this doesn’t mean that abusing women either physically or emotionally okay by any means AT ALL.
Several qualitative studies have shown that women often are much quicker to share negative birth stories than the good ones. I have observed this during my 15 years of working as a doula prior to my midwifery training. I have also spent a lot of time with women who are scarred from their pregnancy/birth/postnatal experiences and I do truly understand that women are abused and violated (Just to add I am from the UK where the cultures are obviously going to be very different), I’m not saying this should be a happy sugar coated article about amazing births but it just doesn’t feel like an article which is trying to empower women to stand up for their rights more to scare them about how they are likely to be violated by HCPs.

(sorry if this is coming across very troll like I really don’t mean to be rude)

You’re not being troll like, you’re opening up a good discussion. I’ve only been living in New Zealand for seven years having grown up in the UK. The birth statistics are very similar. I think women are happy to share their horror stories more readily because the women who have wonderful stories feel bad for telling them to those who don’t have good ones. There’s also a grieving process that’s going on for those with traumatic births where they need to talk it out. I’m in the process of writing a new article about women’s legal rights in the maternity system (in NZ, USA, UK and Australia) and how to choose the right care provider for themselves.

My question is, as a first time mom early in pregnancy, is how do I advocate for myself? I have a rather irrational fear of needles of any kind in my back, and wish for a natural birth without even an iv drip, but I will be having to give birth in a hospital. My concern is that when I tell the staff at the hospital my wishes they will belittle me and tell me that I do not know anything. I do feel confident in my practice, when I told them I will forgo any vaccines while pregnant, she immediately said that I need to do what I feel is best for myself and my child. My concern is with other staff. Any advice to help me get the care I want, not the care they think I need?

Hi Courtney, it depends if you really have to give birth in the hospital or if you could find a homebirth midwife or birthing unit. I have no idea what your situation is but interviewing lots of obstetricians and independent midwives might give you a clearer answer (if you need one). It sounds like your obstetrician is quite open minded if they are supportive of forgoing vaccines.

In terms of advocating for yourself the best you can do it become informed and decide what you do and don’t want to do. Then, your partner needs to be very informed and supportive and feel confident to advocate for you when you’re in labour (since you shouldn’t have to advocate for yourself). A good birth is often a result of careful planning so you’re off to a good start to by asking these questions now. There’s a fantastic book by Henci Goer you might like to read; Optimal Care in Childbirth. It’s difficult to know what the staff will be like on the day. Go to the hospital a few times to chat with them and get a feel for the place. Talk with them about their prefered procedures. If this isn’t the right hospital for you then you can go to another one.

It also depends which country you live in as to what your rights are in the health care system. I’m in the process of researching and writing an article about all of this. If you’re in USA then you have the right to ‘participate’ in the decision making of you and your baby’s healthcare but in the legislation a doctor is allowed to tell you “matters of conscience” and can therefore play the ‘dead baby card’ and manipulate you into doing what they want. This is why it’s so important to find the right team of people now/ start finding them. I think when you’re prepared for different scenarios they don’t take you by surprise if they happen so you know already how to react. It’s important that you find out how your doctor will support you within the system and with other staff. Making a birth plan as an agreement with you and your doctor/hospital is also very useful. Here’s a link to one I used to huge success for a breech VBAC birth last year: http://www.joyfulchildbirth.co.nz/birth%2Bplan.html#.UmiPeFNPTHc

Thank you for the advice! I do not think my insurance will pay for a birthing center, which would be my first choice. I am in the US, and using a certified nurse midwife (nurse practitioner) instead of an ob/gyn simply because they have a better track record here of fewer unnecessary interventions. I desire a mobile (if they tell you not to lie on your back after four months, why are laboring women confined to their backs??) natural birth mostly for the recovery and for the baby. I appreciate the open dialogue in the comments, very professional! Keep it up! I look forward to reading more from you in the months to come.

I gave birth in the US at a hospital for my first baby with a CNM. We hired a doula and also had a clear birth plan that my midwife approved and signed before going into give birth. The staff at the hospital were great the whole time. I was able to eat the whole time, and did not have an IV either. My l&d went as ‘planned’ but I also allowed for the unpredictable too. I would say to educate yourself and communicate with the m/w and hospital about your wishes. The doula really helped keep things on track too. Hang in there.

Birthtalk in Brisbane, Australia (birthtalk.org) do amazing work to support women who have had traumatic birth experiences – I’m now back in Auckland and I would love for there to be similar support available for all women who have not had a ‘joyous’ birth experience. Maybe it is time to get something started here….

Yeah, that would be wonderful! If you fancy chatting about it sometime over coffee that would be great 🙂 There’s is TAMBA here but I don’t think enough people know about it/ they dismiss their experience as ‘normal’ and ‘just get over it’.

I also had 2 “abusive” births…I knew something was wrong but couldn’t pin point it, as I had been verbally, sexually and emotionally abused growing up. I basically was verbally abused to a degree with my first birth, threatened with “being transported” to the hospital if I didn’t try harder(as if I wasn’t trying!) This was my first birth and I was trying my best. I was told to stop verbalizing my pains and discomfort, and that since I “opened my legs, it’s time to be a big girl and face the music”. Nice…
My 2nd birth, I was left often on my own by my midwife, during the most intense part of my labor, when I needed her the most. I was freaking out because my son was coming so quickly and I needed her(went from 5 to 10 centimeters in 2 hours). My stress levels were higher than usual as my mother in law, who lived with me and was cared for thru hospice, died days earlier. This midwife who btw was trained by my first midwife mentioned above, commented “this isn’t your first baby, I don’t understand why you are having so much anxiety” To top it all off, the postpartum care immediately following my sons birth was way too rough and I nearly took a swing at my midwife. And they ended up leaving my placenta out on a table near an outside door, and it was engulfed with ants. I planned on consuming my placenta postpartum, for my benefit. I’m sparing more details, but needless to say, I am not going back to that birth center. I am wiser now and know what I need for my 3rd and final birth. When I read this article, I understood more than ever what had happened to me. I chose midwives because they are women who should understand how to treat another woman, especially during this very important time in a woman’s life. These were not the right set of women for my births…I am very pro-midwives and natural birth, I hate the idea that these events would interfere with women’s decisions to go natural.

Jennifer, I’m so sorry to hear you had such a horrid time. We’re so sensitive during pregnancy and labour that even the smallest things can upset us. Things that we would normally defend ourselves over, brush off or talk back to, we take on board. Birth isn’t ‘just one day’, it can affect us for a lifetime. When you couple that with previous abuse you get a woman who’s even more sensitive and should be supported and looked after even more. Some people just don’t get that 🙁 I’m so pleased this article was able to help you understand that it wasn’t all in your head, you have the right to feel upset and isn’t your fault.

I also have a story. I got married at 19, and started college a month later. When I got pregnant, I was in a happy, loving, and supportive relationship, and despite my youth, I was confident that I could care for my child without dropping out of school, or in any way lessening my, or my daughter’s future prospects.

The stigma against young pregnant mothers is so powerful that at times I feel like it would have been more socially acceptable to get an abortion (and that says something). We were young, and they treated us like the surplus population. At every turn, doctors dismissed my concerns and talked down to me. I was in and out of the emergency room with dehydration because I was unbelievably sick all the time. At 20 weeks, I went in because I felt like there was barbed wire in my chest tearing up my insides. I was screaming in pain in the waiting room, so they took me back, and ignored me for 5 hours until the attack passed, tried to give me morphine which I’m deathly allergic to (and can’t have because I’m pregnant), diagnosed me as a drama queen and sent me home. I never went back for these attacks because I thought A) that is was a normal part of pregnancy, and B) that I was over reacting, and C) that they wouldn’t do anything about it. In reality, I was experiencing organ failure as my gallbladder shut down my digestive system one stage at a time. It got so bad that I it hurt too much to get off the bathroom floor, and that’s where my husband found me when he got home from work. I had to be hospitalized for a week before they could stabilize my vitals enough to do surgery.

No one would listen to me.

When it came time to deliver, I had my husband, mom, and sister with me. My mother only had 2 kids, and actually had a home birth with me because a doctor screwed up my sister’s delivery so badly. My sister had already had 2 kids, and we knew that all the women in my family react really badly pitocin, a drug given to increase severity of contractions. I told my midwife (and my family) that I did not want it under any circumstances. I had an epidural, but refused a second one because I didn’t think I could push if I did. I was yelled at when I cried out in pain, and when I started to become delirious, she tried to give me pitocin. It took my mom and sister physically blocking her from touching my IV to make her back off. When it became obvious that I wasn’t going to be able to deliver, they called in a doctor, and without saying anything to me, my husband, or my family, he ordered a c-section. We didn’t get the courtesy of a bedside manner or even a word of what was going on. After the procedure, the hospital didn’t have any pain meds except morphine available, so I had to wait until the next morning to get more than Tylenol for the hole that they had just cut in my abdomen.

Almost 6 years later, my daughter is starting kindergarten at the top of her class, I’m doing my PhD, my husband and I are still very happy together, and I have sworn that I will NEVER allow anyone to treat me like that again.

Thank goodness your family were so supportive of you. It sounds like you had one trauma after another. I hope you’ve been able to get counselling for this and it hasn’t put you off having more children? There are some really wonderful midwives who would support you with a homebirth. Well done for coming through this with a happy family!

Some O.B.s are abusers. Like my ex-OB in New York City. This article doesn’t even come close to addressing the abuse I suffered during the birth of my daughter. And the danger she put me in because of an inadequate suture (according to my current O.B.) that nearly ruptured when I was delivering my son.

I detail it in my blog “Coercive C-Sections and the Hostile State of Obstetrics”, which can be found by searching Dr. Claudia Holland’s name.

Hi Jumper, Thank you for your comment. I’m so sorry to hear about your birth. I purposely made this article about the ‘low level’ abuse to highlight it as no one talks about it as being abusive. There are so many cases of extreme abuse that never get heard or recognised for what they are. Sadly because the trauma around birth is so socially accepted women almost never take the medical profession to the police. Even sadder is that the laws in America stop women from being able to make decisions for themselves (if their doctor does not approve they can over ride the woman’s choice). I shall look your article up now.

All I can say is bravo to you for writing such a piece of truth. It takes honest and straightforward people to raise awareness about this, and I honestly believe that you are right on . . . how is this not considered a form of abuse? I too had an awful birthing experience and I too have been traumatized due to the impatience and forcefulness of an OBGYN. I hope your article helps other mothers stick up for themselves and not tolerate this behavior any more. Thank you.

Hi Boholistic Mom, thank you so much! I’m doing a talk at our local teaching hospital in a few weeks about this article and going even more indepth with them. I’m really hoping the obstetricians and not just the midwives attend. I wrote this article back in February and had about 2000 people view it at the time. Since then only a trickle of views. But, a midwife friend of mine shared my article last Tuesday and since that day I’ve had 10,000 views! I’m really hoping this makes a difference across the community and for women’s births. We shouldn’t have to put up with this abuse. Birth should leave a woman feeling inspired and amazing. I hope if you decide to have more children you can find someone fabulous to support you and you get a really wonderful, healing experience from it.

Thank you for this article. I have always suffered with feelings of inadequacy after the birth of my first. I was induced and told I could not move by one of the midwives who would roll her eyes everytime she had to come over to adjust the monitor because I had moved. At one point I was crying from fear as I had not planned on an induction and the same midwife quite rudely said “what are you crying about?” I was very relieved when her shift ended and I got a nicer midwife who would let me sit on a ball and move around a bit more. I still ended up having an epidural which effected how well I could push. I was also very sleepy as I had been awake for over 24 hours and had a shot of meptid. I was told that if I didn’t push the baby out after an hour I would have to have forceps. It was like a threat and I was made to feel like I was just being lazy by not being able to push my baby out. After an hour the doctor came in and literally yanked my baby out of me. He didn’t wait for a contraction or do it gradually. This left me with a really bad tear. They diagnosed the tear as a 3rd degree tear when I actually had a 4th degree tear. This has left me with serious problems that means all subsequent births have to be done by csection and I will likely need surgery to repair the damage. Things didn’t improve on the ward, some of the nurses were very rude and I was left in blood soaked sheets for over 24 hours, despite asking several nurses to change my bedding. I struggled to breastfeed and one of the nurses turned round to me and said “you do know that babies need to be fed don’t you” in a very sarcastic manner. That cut like a knife as I was exhausted and felt like a failure in delivering my baby and now I couldn’t even feed her. The experience has left me very traumatized and it took me a long time to build my confidence. The more I think about it the more it does seem like a serious case of abuse. Makes me cry just thinking about it.

Hi Charlene, I’m so sorry to hear you had to suffer through so much. Wouldn’t it be great if childbirth educators taught about your rights during labour and how to handle difficult situations. I hope this article gives some women (and partners) the strength to answer back to such rude behaviour and ask for a new midwife/doctor. As it is most women (and partners) feel this is just what birth is. Hence why it’s been going on unquestioned. Much of the medical profession encourage you to give over your autonomy, your power and your judgement to them. It is still possible to have a vaginal birth after a serious tear. One reason why so many think it’s not is because forceful pushing and bad positioning causes tearing… something they don’t understand and will get you doing on subsequent births. If you would like a vaginal birth I definitely encourage you to go to http://www.birthworks.org classes and find a midwife of the same philosophy… possibly even having a homebirth/ birth centre birth. You in no way failed during your birth, the system failed you. The medical community also like blame women for things that go wrong… too old, too young, too fat, too fit (I’ve heard of women being told that because they’re dancers their perineum is too tight to birth!), too poor, too intelligent… it’s so rare to hear the profession say “we’re failing women, we need to do things differently”. It’s about time they did!

Thank you SOOOOOOOOOOOO much for this article. it is so incredibly important to keep speaking out about this – not just for the mothers but for the new generations being “Welcomed” to the world in such traumatic circumstances.

We also need to educate the partners of pregnant woman so that the person in the room with labouring woman can help make the decisions that are being thrown at them. Thank goodness my husband was there to stop me from signing paperwork that I wasn’t in my right mind to read. Middle of a painful contraction and you place four documents for me to sign? Thank you hubs for reading them and stopping me from signing all of them!

Totally! I couldn’t agree more. Many partners feel like they don’t have a voice and get intimidated by the hospital system thinking they know best. A good antenatal class will teach them to speak up and feel confident. Some men get postnatal depression and I think it often stems from feeling powerless in the birth room

I had a pretty unbelievable birthing experience almost 3 years ago. Very short version is that I was isolated, gassed, and given a c-section without consent.
My birth story was copied into 2 articles online. The comments on those articles are littered with people calling me ungrateful for the medical staff that obviously saved the lives of my baby and myself and calling me selfish for complaining about the loss of my birth plan. Still many other comments even go so far as to say that what happened to me is so unbelievable that I must be lieing to get attention. I am actually glad that there are so many people that are unaware that such negative experiences occur, for that means they have been spared from such negative experiences in their lives. But that does not change the fact that I have been damaged by my experience.

Dawn, I’m so sorry to hear about your birth. It’s awful that the medical profession behave this way. I know so many instances where treatment/procedures are given without fully informed consent. It’s very rare for a health professional to give you accurate information to make a decision either way. So much focus is on informed consent rather than informed refusal. Sadly, many of those people who were bitching at you probably had very traumatic births themselves but feel like they were rescued from something terrible and feel wholly grateful for the system (even if the system caused the problem in the first place). The medical system will blame the patient first before blaming themselves so we create a society of women who feel that birth is a traumatic, frequently dangerous event, women’s bodies don’t work and we need rescuing by the professionals. Fortunately, there are many doctors/midwives who will treat you well, it’s just a shame you have to do so much research to find them.

Sad to say but this is so very true. Personally I had two cesareans with my first two children. My first was because my daughter heartbeat dropped and did not rise again so it was an emergency. After that I received verbal abuse from one of my nurses and my husband did report her. My second was an attempted VBAC with a OB I thought was supportive but wasn’t. First dip in my son’s heartbeat and , even though it came right back up, I was prepped for surgery and off we went. This feeling of failure and my body not working is why I pushed so hard for a VBAC with my third child. I just had my successful VBA2C on August 25th at a hospital an hour away from me with completely supportive OBs so it is possible to experience birth without the abuse, I’ve had it both ways. Thank you for sharing this 🙂

thank you for this! as a midwifery student, this is a very real and eloquently written reminder that each birth is an epic and sacred event for each mother, and they deserve to be treated as such; as goddesses really. I wish every maternity-care doctor, nurse, midwife and doula could read this. I hope to be not only a compassionate, competent and sensitive midwife, but I hope I can change the maternity care worlds in which I work, to be most conscientious and aware of this beautiful and sensitive process we have the honour of being involved in. much love!

Hi Emily, thank you so much for your kind words! It’s fab to hear from a midwifery student. I’ve had a few bits of feedback from some students here in New Zealand and it seems that they’ve been lead to believe that the system here is so wonderful and I can’t possibly be telling the truth. Thank you for your support! I wish you all the best with your studies and it sounds like you’ll be an awesome support to any woman x

Sad to say but this is very true. My first two births were cesareans. My first was an emergency because my daughters heartrate dropped and did not come back up so I was sent for the cesarean. My second I attempted a VBAC with an OB that I thoughtwas supportive. But the first dip in my son’s heartbeat (even though it came right back up) and I was rushed off for another cesarean. After both births, the feeling of failure was enhanced by a verbally abusive nurse that made me cry ,that my husband reported. And our child’s pediatrician that tried to add breastfeeding as a failure even though I refused to let her. This feeling of failure and my body not working is why I pushed so hard for my next attempt at a VBAC with our third child. I had a successful VBA2C on August 25th with a completely supportive group of OBs, that were an hour drive from me in good traffic. So there are abuse free births and care providers out there, I’ve experienced both. Thank you for sharing this 🙂

Hi Erowyn, thank you for sharing your story. So many women feel birth is too traumatic and stop having children. It’s awesome to hear from women who get determined and go for what they want… and acheive it! Congratulations!

Thank you. Ill admit, it was hard because I was so worried that I would end up in another traumatic situation and feel like I failed. It didn’t help that my family was supportive but still asked “why not a csection? Its safer” through the whole pregnancy, added more to it when I choose a hospital so far away. But I found a supportive doctor and hospital, had a supportive hubby, and found an AWESOME facebook VBAC group that helped me stay strong! I have always wanted a big family and didn’t want to fear birth 🙂

Yeahy for you! I’m hoping one day people will realise how natural birth is and always has been safer than a caesarean. It takes a lot of planning to get the birth you want… I bet you feel so proud of yourself! Any plans for more children?! Also it’s people like you who would make great Childbirth Educators. If you fancy looking into it some time http://www.birthworks.org is a great organisation to train through

I am proud of myself, and that is the first thing my husband, my mom and my grandma all said to me is how proud of me they were. For weeks, I still caught myself thinking “Did I really do it? I feel like it was a dream and I’m about to wake up.” But almost 10 weeks later, I still haven’t woke up lol. Yes, we hope to have the very least one more baby. We have a girl and 2 boys and want to try for another girl 🙂 If the next one is a boy, we might even try again 🙂 But hubby and I both grew up with only one sibling and both wanted big families so we will see lol 😉 I think I might. I am a SAHM right now and want to go to school for something, maybe Ill look into Childbirth Educator. Thank you 🙂

Reblogged this on Moments of a Wife & Mother of 3 and commented:
Sad but true. Feeling like a failure and that my body didn’t work is why I pushed so hard for a VBA2C, that I successfully had on August 25th with my beautiful son Garrett. <3

My sister was induced and was examined twice during contractions by the Dr. The 2nd time he asked the nurses to hold her down by her arms and said ‘It can’t hurt that much’. Another midwife later identified that she was having continuous contractions and this was then addressed. As an onlooker, I stood by and did nothing when everything inside me was saying that I was witnessing an assault. That is still how I feel about it 5 years later. Both my sister and I find it traumatic to think about. It’s a very strange position to be in, because on the one hand, you know something is not right, yet on the other you are not sure what is necessary to keep the mother and baby alive and well. It’s very hard to reconcile in your mind as you don’t expect hospital treatment to be pleasant either. To be honest, I still don’t know what to think, except that the Dr’s bedside manner left much to be desired and that I was left in shock by the whole experience.

Hi Megan, that sounds like a really awful experience and yes, it was assault. This is why I’ve called it the socially accepted violence because we’ve been condititioned to think of this as normal and allow it to carry on. But, when we’re faced with it we know it’s not right. Society has dissempowered us from doing anything about it and so the cycle continues. It can be very difficult to find anyone who will help us process this sort of experience because of the attitude ‘stop complaining, you’re both alive’. I hope you and your sister are able to find peace with the situation. Often an empowering next birth actually heals the trauma of the previous birth.

When my sister-in-law was born(in the early 70’s), she was 13 pounds, she got stuck and as a result suffered nerve damage to her right shoulder. Now her right arm is significantly shorter than her left and she has limited use of her fingers on that hand. Her mother was subsequently diagnosed as diabetic.
This is the story that was playing in my head when, at 40 weeks and showing not a single sign of ever going into labor, my ultrasound predicted my daughter would be 11 pounds, 3 oz. My doctor said I might need to consider a c/s, and I readily agreed. My daughter was born surgically the following week and was ‘only’ 10 pounds 4 oz, but with a head circumference that well exceeded all of the charts. 14 years later, still don’t feel a bit of regret at taking the surgical route and not pushing her gigantic head out the natural way. Her brother came the same way – we elected c/s 2 weeks early, and again had a perfect experience – 8 pounds 2 oz. I don’t feel the slightest bit traumatized.
I might have made different choices had I not known what happened to my sister-in-law, and seen her have difficulty with her hand. My doctor didn’t pressure me, just offered the option and I decided it was the one that felt right for me.
I do support wholeheartedly a mother’s right to birth in whatever way feels right to her, vaginally or surgically, medicated or not, and in whatever environment or position feels right for that mom.

Hi LeeAnn, thank you so much for sharing your postive experience. I agree, when women make their own choices and take responsibility for their births, by whatever route, we produce empowered and confidence mothers.

You’re right, very few hospital procedures are based on sound research evidence. Epidurals were never tested before their widespread use. It seems that pregnant women are guinie pigs for procedures and drugs since no women in her right mind would volunteer for medical testing when she’s pregnant.

the best personal reply to this is silence, as pain and even death can speak volumes to the silence of the cry of hurting women and husbands trapped devastated by the care and then permanent trauma, and even loss to them selves and even their infant by unwanted and forced help without consent or fear tactics to gain it.. here in Saskatchewan we are forced into being the Ginny pigs for every passing student even when procedures are no longer needed by reason of death .the reason is “they need the experience” with no thought of the emotional state of well being f the patient. we are no more cared for than the aborted baby in the next room no more than a simple procedure for the benefit of the students.

Hi Melody, thank you for commenting. You’ve got me looking up the Health Care Rights in Canada, thank you for that. It seems that the law covers the right to health care but not the treatment you receive within the system. I just can’t find any legislation that says you have the right to a support person, the right to accept or refuse etc. I can’t understand why such a country would allow this?! Maybe it’s there, just hidden? I know that midwives and obstetricians need to perform a certain number of episiotomies in their training to qualify. It makes me sick thinking about it. I think there is going to be a huge, world-wide shift to birth a home within the next 20 years to avoid all this unnecessary treatment within the system

Reblogged this on Wholebeing Updates and commented:
Vital information for the well being of mothers to be and their babies! Because of fear and lack of understanding of the birthing process and what was expected of me, my first delivery was excruciating. I actually tried to walk out of the hospital! Second time around I knew what to do and the staff were all supportive. A transformative experience!

My labor and delivery experience was so terrible that I do not want to (and am scared to have another child). My daughter is 2.5 and I still have a lot of stress from thinking about it. My husband (bf at the time) was deployed to Afghanistan and I had our daughter alone. I was induced. I had a small tear and also a epidural. The combination of the two made it so my legs felt like jello and when I tried to move to even scoot up in bed I felt like my vagina was going to re rip. they also had to put in a cath bc I couldn’t feel to pee. They had me on so much pain medicine and I was going on no sleep (and no food after birth. It wasn’t offered and I had no one to get me anything) I was going cross eyes from being so exhausted. I was treated so horrible bc I wasn’t up walking around or interacting with my daughter enough. And bc I was asking for extra help (I was alone. Obviously in asking for more help than the other women who have the fathers and family present). They held me for 3.5 days. They sent a social worker in my room who was talking about all kinda of things (at one point talking about assistance for help with baby items) what?? I did my daughters entire nursery in pb kids (not relevant but why would she assume I couldn’t provide) and also talking to me about parenting and help. Bc of the hard time I had I was treated as if I couldn’t care for and love my child. All I needed was to go home. Be off pain medicine and get a hot shower so I could feel human. Nurses were rude to me bc I needed extra help. It was so horrible… They sent a social worker to my home a week later. The woman didn’t even want to come in bc she knew it was ridiculous. I asked her to come in anyways just to show her our home. She left and I never heard from her again.

Hi Courtney, thank you for sharing your story. I have a couple of clients here in Auckland who went through a very similar thing. I don’t think it’s enough to say they are under staffed or sleep deprived. There are standards of human decency that should be instilled in training and each morning in staff meetings. Knowing now how things can be during labour it’s likely that if you do have another baby you’ll seek out a wonderful midwife who will support you properly, maybe even as a home birth. It can be very healing to do it again feeling empowered.

Wow, very interesting article. I never thought about doctors bullying and emotionally abusing women. It recently happened to my sister, her dr. was getting impatient (after saying numerous time, “I don’t feel bad that you’re in pain, if you had a c-section you could’ve avoided this”)and his exact words were “I order a c-section, you can deny it, but if the baby dies, it’s your fault, not mine” so she was bullied into a c-section for no medical reason at all. great article!

Hi Hillary, thank you for posting your sister’s story. Isn’t it sad that as a society we accept this sort of treatment? I hope your sister is able to get some counselling around this? It can have such an affect on a woman. Some people should never be allowed onto a maternity ward!

To me is very sad to read about these experiences for two reasons. First of all, because they bring back to me all my terrible memories of giving birth to my child. Secondly, because being from Eastern Europe, I always used to think that experiences like these are happening only here, in regions that use to be under the authoritarian communist regimes. I was assuming that in countries that knew no dictatorship women enjoy a more “democratic” treatment while giving birth and that human rights are respected.

To me, reading this article, the message is that there is no hope. No matter the culture, the political background, the living standards’ level, human beings are constructed so that if somebody, a woman giving birth for example, is in a vulnerable, exposed situation, there are big chances that other humans will be ready to abuse and insult her. Just because they can. And yes, that brings this type of abuse at the same level with rape. Women are raped by men everywhere in the world just because men, being physically more powerful, can do it.

Abuse seems to be in human nature therefore we have to learn to protect and defend ourselves. For that reason articles like this are very important and useful, I can only hope that many women will get the chance to read it.

Hi Klara, thank you for posting your comments. We’ve had 26,000 people read this article so far (24000 in just the last two weeks!). I think there is hope. This sort of behaviour has been going unchecked for nearly a century and now it’s time to take our power back. This is why I wrote this article… to give women the confidence and power to answer back, to know this isn’t right and to help them make more informed decisions. Also, so her partner can be more protective in the labour room. I’m working on a new article at the moment on a woman’s legal rights in maternity care.

The birth of my daughter is now 2.5 years ago, but I still cry when I think about it. I was induced 3days overdue because there was a free appointment in the hospital. I begged to wait longer but the doctor didn’t care. They were happy to give me the epidural after 16 hours of labour, and tried to get her out with the forceps, after 18 hours. The catheter got torn out during a contraction, blood everywhere, today I am still having pains when peeing. It finally took 3 staff members to rip out my baby (senior doc at the forceps, midwife pushing my knees back, junior doctor with his bodyweight on my belly) plus my husband holding my shoulders so they would not pull me off the table. My mother was there, too, but she lost conscience twice (she was with my sisters 2 births and loved the calm and wonderful experience). I was in shock for weeks, still don’t know exactly what was torn inside me, just that the OB gyn (I saw 6 weeks after birth) said the scar tissue is so deep and tight, that another vaginal birth probably would fail in the first stages of pressing.
Also intimacy with my partner became a big issue, not because of the pain, but because I just can’t bear being touched anywhere near my vagina. Sex turned into a very rare and for me unpleasant part of our life. Still we managed to get pregnant again, and after a lot of talking, crying and counseling I am booked in for an elective Cesarean. Not that I like the idea of having my abdomen cut open, but it means a lot less fear to me than the prospect of another vaginal birth.
I am still not sure if they made any mistakes, but I am sure that in many ways I was ignored and not taken serious by the hospital staff.
The more I research, the more I hear about women having similar feelings of violence and even abuse after birthing. Thank you so much for this article! It doesn’t point the finger at over sensible women, but creates awareness for a (it seems) common problem in the birthing practice around the world.

Hi Liz, I’m so sorry to hear about your very traumatic birth. No wonder you’ve been suffering ever since. There is very little patience in hospitals and often very little encouragement of movement to help the baby get into the right positions. It makes me shudder what you went through. Have you had specific counselling for this with someone trained in birth trauma? There’s a very good book called ‘Silent Knife’ that you might like to read as well as ‘Ended Beginnings’. You can get them both on Amazon. Definitely worth reading before you birth again. Wishing you all the best x

18yrs ago I underwent one of the most traumatic experiences of my life.
I was 17yrs old, 25wks pregnant and was in labour.
My antenatal card stated in very clear, very large, very red, letters that I was allergic to salbutamol. I was also given a red hospital wrist band (denotes allergies) with salbutamol written in black block letters.
The drug routinely administered to stop preterm labour at the time was, you guessed it, salbutamol IV.
I have what is referred to as paradoxical bronchspasm (salbutamol, or ventolin/albuterol causes me to have asthma attacks), and sure enough, I was given an asthma attack by well-meaning, but negligent, obstetricians. I was treated by being given pure O2, and epinephrine to stabilise my asthma so they could continue to administer the drug that was literally killing me.
72hrs later, and still pregnant but 4cm dilated, I was transfered to a second hospital, where I continued to go in and out of labour for the following 4 weeks.
At 29wks, whilst on complete bedrest in the antenatal ward, I had to tell 3 shifts of midwifes that I was in labour, and it wasn’t until the Drs did their rounds, and an internal exam, on the ward in a room I shared with 3 other women, that I was finally taken to L&D and the decision to deliver my son through an emergency c-section was made.
It didn’t stop there though.
Whilst my son was taken to NICU, I was placed in the postnatal ward with 3 women and their newborn babies.
My son was transported overnight to a hospital with a humicrib, and I was transferred the next day, not under pain relief, to a hospital separate from my son.

Hi Bast, thank you for sharing your story. There’s so many types of wrongness and to have to deal with that at such a young age. Negligence on so many occasions and total ignorance of how you might be feeling and the effects of separating you and your baby as well as putting you with other new mums. I hope your family were very supportive of you and your son and you were both able to heal from all of this. Sadly, the hospitals are full of well meaning people doing a bad job. It’s not their intention that matters since the outcome is still the same. I hope this hasn’t put you off having more children if you were planning on more?

the problem is that women just dont think for themselves and trust others when they should be trusting their own bodies and SPEAK UP!! i have had 4 YES FOUR VBAC’s!!!!! all because i demanded to be allowed to labor,, speak up and be heard!!! you are woman, lets hear you roar!!

Seaason, It’s not just that easy to fix. I spoke up.. I screamed.. I was gassed, by a nurse that lead me to believe that the mask contained oxygen, when it didn’t. Telling women to trust their bodies & demand their right to birth their way, isn’t enough. My abusive birth is NOT my fault. I was surrounded by medical professionals who refused to acknowledge that I was demanding my rights. If a single person had stood over me & said “hey, wait, what’s all this fuss?”, my birth would have probably been completely different.

Women, in general, should be more responsible for their births. There is a horrible lack of ‘information’ behind ‘informed consent’. But, there are also a LOT of ‘acceptable’ practices in the obstetrics & gynecological fields that are needless, inappropriate, and/or dehumanizing. And, a lot of women, who are “trusting their own bodies & SPEAK UP” are still abused.

You are totally right Dawn. My new article about knowing your rights will incorporate this. A woman doesn’t deserve to be raped just for wearing a short skirt and a woman doesn’t deserve abuse just because she’s birthing in a hospital. We are not responsible for other people’s actions. When the medical profession as a whole finally admit to this violence and abuse things will start to change… even if for nothing else than their fear of being sued.

Yeahy for 4 VBACs Seaason! You are right that many women don’t research, they assume the medical profession have all the answers, always do the right thing with her interests at heart. Sadly it’s not always the case and even sadder is when they go against your best interests when you’re telling them straight what those interests are. I’m so pleased you found the right people to birth with you!

Such a wonderful article Sam…you really ‘hit the nail on the head’, so sad that this is many womens experience of child birth. I changed Doctors 4 times before finding one who I knew was going to respect me and my choices, sad that I had to search so hard but did find a wonderful Doctor. When I had discussed hypnobirthing with the previous Doctor he said “I’ll remind you of this [that I didn’t want medication/pain relief] when you are climbing the walls in pain and begging me for medication”. Well, since this I have had 2 amazing births with a great deal of pressure but certainly not unbearable pain. It is wonderful that there are people like you advocating for pregnant and birthing womens rights and empowering women to trust their bodies to birth naturally without fear and therefore without great discomfort.

Thanks Laura! Yep, heard that story too many times. As well as the eye rolling, the refusal or ignoring of the birth plan, the snide remarks over the birth plan and just offering pain relief when it hasn’t been asked for. Congratulations on your amazing births and well done for persisting in finding the right doctor for you 🙂

I was told not to come into hospital with my first because I didn’t sound in pain on the phone. I ignored them and turned up. Got sent to a waiting room where I felt the urge to push. Baby born 5 mins later. Placenta got stuck so good thing I made it there in time. Next time my entire labour was only 2 hours 20mins. This time they tried to make me labour on my back but I got hubbie to help me into kneeling position and baby was born after 3 pushes. Midwife response…..you might have had a quick labour but I still have 3 hours paperwork to do! Bitchy comment straight after birth. Lovely!

My little boy is now 6 months old, and had a difficult birth. Throughout my pregnancy my anaesthetist was trying to convince me my heart wouldn’t cope, at one point wanting me to go to another hospital where they could deal with me better, even though my cardiologist was supportive of me attempting a natural birth and at my local hospital. After I had convinced her that I was not changing hospitals she spent the rest of my pregnancy attempting to convince me to have an epidural, once when a student was present (I always allow students as I know I am a difficult case and think the more doctors, midwives etc that have experience the better for others with the condition) she brought up the epidural again, I said that I am not saying yes and was going to see how labour progressed, she said something along the line of how I was going against expert suggestion etc. I pointed out that I had done the research, spoke with my cardiologist (who had written her 2 letters agreeing with me) and that at the first sign of heart failure I would be perfectly happy to comply with whatever medical intervention was required.

When I actually went into labour I had a long latent phase, after 5 days of contractions my baby stopped moving so I went to hospital to find his heart was dipping but returning and I was 2/3cm they wanted to induce me, but couldn’t use hormones because of my heart condition. I was sent to wait on the ward, where I made it clear to the anaesthetist that I had not said yes to an epi, by the time a room was available on L&D it was 5:30pm got up there to be told they didn’t want me to labour over night so I would be induce early morning and was sent back down to ward. At around 9ish I asked when I could have more painkillers and was told not til 11, I was really trying to last but by 10:30 I was in almost continual pain and shaking. The first midwife asked if I was having a panic attack, when I said no she didn’t believe me straight away, but another came to help, I was 4cm so was sent back upstairs and husband was called.

When I got up to L&D I met my midwife who was lovely, and 2 anaesthetists arrived asking about putting the epi needle in (but no drugs) in case it was needed, I agreed as had a feeling I might need it after the baby not moving much, they returned however saying the consultant said have to have a trial epi as he wouldn’t sign off on a full one without having had a trial first. Midwife was great and very empathetic- having to make a difficult decision without husband… I agreed in the end.

So was laid in reclined position and strapped to monitors, after 30ish mins it started wearing off and I had gas and air, every time I moved the monitor lost the heart beat so I decided to stay put, in a lot of pain after another 4 hours I was 6cms and asked for a full epi my midwife was supportive and said she thought it was the right decision, although it didn’t work properly. Within a couple of hours my baby’s heart dipped much worse and didn’t come up, I was rushed to theatre ~(with no time for consent) as we were going my midwife asked if I understood what was happening and held my hand. In theatre they topped up my epi but it still hurt, the doc was getting abit cross and saying is it actually pain or just abit of pressure, I think I shouted something about being able to feel his nail, after a few attempts at the epi, the doc wanted to do a general, my midwife was saying give them chance, he turned round and said she may be your patient but this baby needs to come out now, so I said ok. Turns out he had the cord round his neck twice, had no waters (although no one knew they had gone) and had pooed, and he wouldn’t breathe, thankfully he was fine.

We were very lucky, my midwife was great, she continued to be, she made sure I came round before putting a nappy on (even though he pooed on hubby) as I wanted to see the sex myself, and when it feeding as I was still drifting in and out hub was saying I really wanted to breastfeed and another nurse was trying to convince him to let her cupfeed as baby probably wouldn’t latch on my midwife stuck up for me and latched him on.

I did not find my birth traumatic, but I think this is partially because of the amazing midwife and partially because of the amount of research and prep I had done for different eventualities.

Hi Verity, thank you so much for sharing your story. It sounds like you really stuck up for yourself along the way. You can see how much bullying into their way of thinking there is. I’m so pleased you kept doing what you thought was right and so pleased they kept their hands off until they had the all clear from you. This is when we feel we have an empowering birth.

I am an attachment and birth trauma therapist — what the world needs to stop denying is that the BABY is – we are were — sentient beings at birth. The baby is experiencing this and wiring this up … in relationship to the mother. The baby is being wired to feel the world is painful, violating, scary and without enough resources, to feel separation, disconnect, loss, and anxiety with the mother. I help mama-baby to recover from that, and to include the father who is often the powerless witness.

In Chapter 5 and 6 I discuss the impact of this birth violence on the relationship between the woman and the man … that impacts their mothering, father, marital relationship for their lifetime, because our culture does not acknowledge that it harms women, babies, and men. People are deeply violated and then told to go home and be happy. Our culture, individually and collectively we are expected to suppress the violating experiences at the hands of professional caregivers.

These are horrible stories! I’ve never had a baby in a hospital… that was a last resort, which thankfully I didn’t need. It was the same for all three children, hand the jolly joker the birth plan… he pretends to read it, and then says, “Oh, all this goes out the window if I say so.”
“Umm… no, you are to follow precise directions.”
“Little lady, I’m the doctor, and you are not… now you don’t worry your pretty little head about this and I’ll take care of everything.”
“Little doctor, I am the person paying the bill, you are my employee… you will follow precise directions.”
You know… I’ve never had this problem with a contractor…they just follow directions.

I don’t think they understood that they were backup… or maybe they were just easily confused. Or, quite possibly they thought they had scared me enough, I got some crazy birth stories from those guys, and peculiar information on my condition. Apparently I had several rare and unusual conditions, that would require me to follow their directions. They also spent an unusual amount of time with me… nurse… “Hey, why were you in there so long with Barney Fife?”
“Beats me… he was trying to chat with me.”

All the children were born with no problems, quick, easy births… and I wandered about eating a giant sub, rocking in the chair, and doing whatever it is that I felt like… I was never once told I couldn’t do anything that I wanted to.

Now if you want to go to the hospital, get an advocate, give he/she/it your power of atty while you are in labor. Wait until they want to do something you don’t like… then have your advocate produce the power of atty… now, wait for hospital legal to show up… you should have bought enough time to do things your way. Nothing scares a doctor like legal papers 🙂 (Note: Do pick someone smart enough to realize that if you are actually hemorrhaging, they won’t push it.)

Don’t play ball, they can only hurt you if you let them. YOU are in full charge… there is nothing wrong with you, you are having a baby. This isn’t a medical condition, nor should it be treated like one.

Yes, I do sound a bit militant.. but if a war is being fought against you, YOU need to fight back. It’s YOUR baby, and YOUR birth… do what you please. Within reason, there ARE reasons for sections, there are also reasons for other interventions…. OTOH, those reasons are few and far between.

Another form of abuse that the hospitals subject women to is trying to rush them in and out as quickly as possible; often inducing them for no good reason. I was induced because it was my first child and I didn’t know any better. I was having contractions every few minutes and no pain. After the medicine, I had to get an epidural because I was in so much pain! Then after a few measly attempts at pushing, they rushed me in for a c-section. I was so stressed out, I began to vomit from panic attacks. During the procedure I started losing consciousness, followed by feeling as though I was struck by a lightning bolt (adrenaline shot due to my dramatically dropping heart rate a blood pressure). Then two days later I found the epidural needle still in my back! I still have a hard time thinking about the experience and now that I’m pondering having another, I’m terrified of there being a repeat of the whole experience. Thank you for bringing awareness to the issues women face during delivery.

Hi Melissa, thank you for sharing your story. You’re right, any procedure not done for a medical reason is not medicine. Inductions for dates and cesareans for failure to progress isn’t medicine. We don’t do heart by basses on 65+ year old men just because they’re 65! Or give chemotherapy to 80 year olds just in case they have cancer. Why should the medical profession think they can do medical procedures on pregnant/labouring woman without an illness? I’m so sorry you had such a horrible experience. With the right planning you’re likely to have a really wonderful second birth. I definitely recommend a good homebirth midwife and a doula. Hypnotherapy can be very good for facing our fears in a safe environment too but you need to find the right person who deals with birth trauma. Good luck!

I am so saddened by so many of these stories. I guess it’s easy to understand why I avoid doctors and, should I ever have a child, will be attending to my own needs at home. We women have been capable for centuries. Why we’re suddenly treated as if pregnancy was a disease is beyond me.

I’d like to leave a comment that is positive. I had a natural childbirth at a free-standing birthing center (in the USA). I ended up having 3 midwives (CNM’s) as it was a very busy night and I was there for two shifts. My labor was excruciating, I had back labor, but in my hips it literally felt like my hips were trying to explode off my body with the force similar to being slammed in the hips with a baseball bat every contraction. In addition, my hips literally felt like they were being lit on fire every contraction. And yet, I managed to have an un-medicated vaginal birth. I had the support and great respectful care of my husband and midwives. I also had a doula, but that ‘s another story. In the end, I ended up with a pretty bad 2nd degree tear which still gives me some issues now and then. All in all, there are several things that I would change having gone through that experience. I have discussed these issues with my new midwives (I moved to another state or I’d probably be using the same midwives) but they were minor and I never once felt out of control, or disrespected by my care providers and I ended up being very empowered by the whole situation. When breast feeding got hard, I had a newly found inner strength to push through it. When I thought I’d die from lack of sleep, I dug into the new strength that I had from a very empowering birth experience. That said, let’s hope this baby just slides out without the baseball bat!!!!

I can totally related to this article as I was abused physically, mentally, emotionally and spiritually while giving birth to my first born. I had an elaborate birth plan which was to have a water home birth with no medication. One of my midwives recommended me a transfer which at first I decline and afterwards again too because I was informed I will be able to discuss my options with the OBGYN on call.yea right! This OBGYN totally disrespected me and abuse me! She was yelling at me while I was in labour and disregarded my birth plan. She preformed several illegally( I said NO I do not consent) and she did the procedures always!
I’m looking to sue her and the hospital because I later found out that she wasn’t allowed to practice without a supervisor as stated on her conditions for registration in Australia.
I’m still traumatise by this all and deeply hurt!

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